ANATOMICAL BASIS OF CLINICAL POTENTIAL OF PORTACAVAL FIBROUS CONNECTIONS
DOI:
https://doi.org/10.52340/jecm.2025.02.26Keywords:
portacaval, fibrous, connections, anatomical, basisAbstract
The aim of this study was to investigate portacaval fibrous connections (PCFCs) in the human liver, based on factual material archived at the Department of Topographic Anatomy and supported by recent research findings, in order to assess their potential clinical relevance. PCFCs are regular intrahepatic anatomical structures that develop during the embryonic period and form at the points where major portal tracts intersect with hepatic veins.
Morphological analysis revealed that PCFCs are most frequently observed in liver segments I, II, and III. Based on the findings, the consistent topography and structural stability of these connections provide a rationale for considering their potential application in endovascular portacaval shunting in cases of portal hypertension. This approach, which involves targeted perforation without stent placement, may reduce risks associated with the intervention and enhance the potential effectiveness of the procedure.
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ლეილა ჯანდიერის დისერტაცია „პორტული კომპლექსის ნაღვლსისხლძარღვოვანი ელემენტები მექანიკური ქოლესტაზის პირობებში“ 2019 წ.
რევაზ ოთარაშვილის დისერტაცია - „ნაღვლის სადინრების გავლენა ღვიძლის ვენებზე, მექანიკური ქოლესტაზის და ქოლანგიტის პირობებში’’ 2022წ.
Patarashvili L, Gvidiani S, Azmaipharashvili E, Tsomaia K, Sareli M, Kordzaia D, Chanukvadze I. Porta-caval fibrous connections — the lesser-known structure of intrahepatic connective-tissue framework: A unified view of liver extracellular matrix. World J Hepatol 2021; 13(11):1484-93
Couinaud C. Surgical anatomy of the liver revisited. Paris; 1989:29–39
Yamamoto M, Katagiri S, Ariizumi S, Kotera Y, Takahashi Y. Glissonean pedicle transection method for liver surgery. J Hepatobiliary Pancreat Sci. 2012;19:3-8.
Чануквадзе И.М. Строение и взаимоотношение соединительнотканных покровов портальных комплексов и печеночных вен. Хирургическая анатомия и экспериментальная морфология печени// Сборник научных трудов ТГМИ. Тбилиси, 1988.- С.13-33
Chanukvadze I. & Archvadze V. (2003) [Surgical anatomy of main intrahepatic portal tracts]. Zentralblatt fur Chirurgie 128, 958-962
Ikeda T, Okano S, Hashimoto N, et al. Histomorphological investigation of intrahepatic connective tissue. J Hepatobiliary Pancreat Sci. 2021;28: 76–85.
Martinez-Hernandez A, Amenta PS. The hepatic extracellular matrix. I. Components and distribution in normal liver. Virchows Arch A Pathol Anat Histopathol. 1993;423:1-11
Rojkind M, Ponce-Noyola P. The extracellular matrix of the liver. Coll Relat Res. 1982;2:151-75
Nakanuma Y, Sasaki M, Terada T, Harada K. Intrahepatic peribiliary glands of humans. J Gastroenterol Hepatol. 1994;9:80-86.
de Jong IE, van Leeuwen OB, Lisman T, et al. Repopulating the biliary tree from the peribiliary glands. Biochim Biophys Acta Mol Basis Dis. 2018;1864:1524-1531.
Richter GM, Roeren T, et al. Portal hypertension and TIPS. Chirurg. 1995;66:555–565
Garcia-Tsao G, Bosch J. Management of variceal hemorrhage. N Engl J Med. 2010;362: 823-832
Bosch J, Garcia-Pagan JC. Complications of cirrhosis: portal hypertension. J Hepatol. 2000;32(Suppl 1):141-156.
Boyvat F, Aytekin C, et al. Transjugular intrahepatic portosystemic shunt creation in patients with portal hypertension. Diagn Interv Radiol. 2014;20(3):276-282
Nolte W, Manke H, Schindler C. Doppler studies post-TIPS. Ztsch fur Gastroenterol. 1998;36:491–499
Chanukvadze Ilia. Portacaval fibrous connections: little known anatomical structure of liver Romanian Medical Journal, volume 64, issue 1, pages 43-48 (2017)
Chanukvadze Ilia. Vasculo-fibrous architecture of the magistral portal complexes Romanian Medical Journal, volume 63, issue 3, pages 214-218 (2016).
